Emotion recognition in depression and anxiety

Abstract

Investigating the biased processing of emotional faces is essential to our understanding of emotional disorders, particularly given the evidence for depression-related biases in processing positive emotions. The present studies explored emotion recognition (ER) in outpatients presenting for assessment and treatment of emotional disorders, using an ER task that involved watching 40 computer-morphed faces changing from neutral to fully emotional expressions (happy, sad, angry, fearful). In Study 1, 644 outpatients (57.6% female, M age 31.3, range 18-76) completed the ER task, questionnaires, and a clinician-administered, semi-structured diagnostic interview. Study 2 examined the effect of oxytocin on ER and visual attention in 60 outpatients (61.7% female, M age 27.3, range 18-65) using a double-blind, placebo-controlled between-subjects design. Thirty participants with a current mood disorder and 30 with an anxiety disorder (only) received intranasal oxytocin or placebo before completing an ER task with eye tracking. In Study 1, depression severity was expected to be negatively correlated with ER accuracy and intensity. This hypothesis was not supported. Increased age was associated with lower accuracy and slower recognition of sad and fearful faces. In Study 2, the primary hypothesis was that oxytocin would improve ER for happy faces in depressed participants, based on previous findings that oxytocin enhances ER, and that depression is associated with biases in recognizing positive emotions. Diagnostic group (i.e., presence/absence of a mood disorder) moderated the effect of oxytocin on ER, but not in the expected direction: Oxytocin significantly slowed the speed of ER for all facial emotions in participants with anxiety disorders, but did not affect performance in participants with mood disorders. The main effect of oxytocin on ER accuracy, speed, and fixations in the eye region was not significant. The results were not influenced by age or gender. Significant Group x Drug interactions showed that depressed participants who received oxytocin made significantly fewer fixations in the eye region of happy and sad faces than anxious participants who received oxytocin. Before oxytocin can be used to target ER biases, additional research is needed to examine the differential impact of oxytocin on ER speed in patients with anxiety versus mood disorders.